{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T12:32:14Z","timestamp":1779366734764,"version":"3.53.0"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2023,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Pregnant patients with a history of hypertriglyceridemia are at increased risk for development of acute pancreatitis. When conservative management fails to maintain triglyceride levels less than 250\u2013500\u2009mg dL\u22121<\/jats:sup>, implementation of pregnancy category C medications to prevent pancreatitis must be considered. Plasmapheresis rapidly reduces triglyceride levels and has been reported as a successful third\u2010line therapy for hypertriglyceridemia\u2010induced acute pancreatitis in a limited number of pregnant patients. Use of preventative plasmapheresis as a bridge to delivery is not well characterised.<\/jats:p><\/jats:sec>Case Presentation<\/jats:title>We report an outpatient plasmapheresis regimen for the control of hypertriglyceridemia in a pregnant patient with a history of diabetes mellitus, hypertriglyceridemia, distal pancreatectomy, and repeat pregnancy loss. During the second trimester, refractory triglyceride levels increased up to 3438\u2009mg dL\u22121<\/jats:sup> by 28\u2009weeks gestation. Given the patient's high risk for recurrent pancreatitis and limited remaining pancreatic parenchyma, she was treated acutely with two single\u2010plasma\u2010volume exchanges with 100% albumin over 2\u2009days, decreasing the triglyceride level to 559\u2009mg dL\u22121<\/jats:sup>. Subsequent plasmapheresis every 7 to 9\u2009days maintained a triglyceride level of 320\u20131296\u2009mg dL\u22121<\/jats:sup>. The patient experienced no adverse effects and remained outpatient until successful scheduled delivery for hypertension at 33\u2009weeks gestation.<\/jats:p><\/jats:sec>Discussion<\/jats:title>For select patients, early escalation to plasmapheresis may prevent morbidity and mortality associated with acute pancreatitis. An individualised plasmapheresis regimen can serve as a bridge to delivery, which requires close observation and the coordination of a multidisciplinary team.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.12985","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T01:44:07Z","timestamp":1691718247000},"page":"413-415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preventative plasmapheresis in a diabetic pregnant patient with hypertriglyceridemia and distal pancreatectomy"],"prefix":"10.1111","volume":"33","author":[{"given":"Keenan O.","family":"Hogan","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1933719108330569"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X15594082"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.02.034"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.161"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2015.11.008"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2021.12.006"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.10063"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2017.09.028"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21705"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21453"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MJT.0b013e31825b9e98"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosissup.2019.08.032"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525\u20101594.2009.00810.x"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.20192"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010013\u20102786\u2010z"}],"container-title":["Transfusion Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.12985","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T11:20:59Z","timestamp":1718364059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tme.12985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/tme.12985"],"URL":"https:\/\/doi.org\/10.1111\/tme.12985","archive":["Portico"],"relation":{},"ISSN":["0958-7578","1365-3148"],"issn-type":[{"value":"0958-7578","type":"print"},{"value":"1365-3148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,10]]},"assertion":[{"value":"2023-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}